HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED `
Date 1!�Il 1� Permit Number:
RECEIVED
- -
Building Permit Application DEC 17 2018
Planning and Development Services ST. Lucie County,Pf4iifffi.iliL
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof —
PROPOSED IMPROVEMENT LOCATION:
Address: 5211 BOWLING GREEN DR, Fort Pierce, FL
Legal Description: LAKEWOOD PARK-UNIT 2-BLK 11 LOT15(MAP 13/11 S) (OR 3956-1796)
Property Tax ID#: 1301-602-0024-000-9 Lot No.
Site Plan Name: Block No.
Project Name: Re-Roof
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Re-Roof-cc Tear off old shingles and install new shingles.
CONSTRUCTION INFORMATION:
Additional work to be ertormed under this permit—check all appy:
HVAC Gas Tank []Gas PipingShutters a Windows/Doors
11 _
Electric 0 Plumbing Sprinklers Generator W1 Roof 412 Roof pitch
Total Sq. Ft of Construction: 1746 S Ft.of First Floor: 1746
Cost of Construction:$ 6500.00 Utilities:Sewer Septic Building Height:
OWN ERAESSEE: CONTRACTOR:
Name Fritzma Valsaint Name: RODERICK J WALLLER
Address:4708 Palmetto DR Company: SUNRISE CITY C. H .D .O. INC.
City: Fort Pierce FL State: FL Address: 130 S INDIAN RIVER DR.#202
Zip Code: 34982 Fax: City: FORT PIERCE State: FL
Phone No. Zip Code: 34950 Fax: 772-907-0420
E-Mail: Phone No. 772-201-2850
Fill in fee simple Title Holder on next page(if different E-Mail: RODWALLER1 @GMAIL.COM
from the Owner listed above) State or County License: CCC1327208
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: 130 S INDIAN RIVER DR.#202 Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit..
St. Lucie County makes no representation that is granting a permit will authorize thepermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will,in all respects, perform the work
in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commgQcing work or recordinp,vour Notice of Commencement.
C
C
Signature of Owner/Lesse /Contractor as Agent for Owner Signature Y 6ntractor/Licensi Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST.LUCIE COUNTY OF ST.LUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 17TFday of December 2018 by this 17TIday of December 20 18 by
RODERICK J WALLER RODERICK J WALLER
Name of person making statement Name of person making statement
Personally Known X OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Type of Identification
Prod Produced
(Signature o taVwr A b c 5c- Florida (Signature of N to u I -
111 , Sophia Harris Nftry Public Stile of Floride
Commission No 0 MyCommiseim 211 1573 0 Sophia H rri fs�8)
F:x�reso5130110220 Commission No. Commias;dii'GG1238e73
4W ft., Expires 05MM020
P4 A
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17